“ER” at 25 by Nate Blake

On September 19, 1994, ER debuted on NBC. In a first for prime-time medical dramas, it did not talk down to viewers. The dialogue did not re-work medical jargon to make procedures easier for audiences to understand. It immersed the viewers into a TV world where doctors and nurses actually say the things doctors and nurses would say, at least during the numerous condensed trauma room scenes and surgeries contained within each episode. Some patients were only on screen for a minute or two, rather than being the focus of the entire hour. The focus was on the doctors, and the stresses of their workplace. Network execs were unsure it would find an audience. They didn’t think viewers would be able to invest in the chaos of the environment depicted. They were wrong. ER quickly became the most watched show on television, and held on to that title for most of the 1990s.

Oh, and did I mention the blood? It’s a testament to how grizzly some moments of ER were that after watching shows like Game of Thrones and Breaking Bad, I still cringe far more when thinking about certain images from a quarter century old network medical drama. The series’ writers also had a knack for providing memorable characters, even after the entire original cast had left. That’s why the show, which was a ratings behemoth for 10 of its 15 seasons, stuck around so long. Its reputation still holds its own despite the last 20 years of inventive long-form shows that have pushed the boundaries of television.

The later seasons are a mixed bag. At one point the producers, realizing that Grey’s Anatomy had overtaken the show in the ratings, decided to borrow some of the stylistic traits of ABC’s drama, and most attempts to do that were pretty lame. I’ve known a lot of people who are fans of both shows, and each series had its own stylistic flourishes and unique tone. It didn’t work when ER tried to be Grey’s, and to the latter’s credit I don’t think it would have lasted as long as it has (it has now been on longer than ER), if it had just been ER with more sex.

ER did change the way viewers experienced scripted TV. It was one of a handful of shows that helped pave the way for TV dramas that had the look and feel of film, as well as the budget of one. Even though the early seasons aired in the 4:3 aspect ratio, they were shot in 16:9, just like blockbuster films (those episodes now stream in 16:9). The fast-paced trauma room scenes incorporated lengthy stedicam shots that were often done in one take. Once ER arrived, you could watch a TV show and see how its style was influenced by auteur directors like Steven Spielberg.

An impressive number of writers, directors and producers made their mark on the series. Some, like David Nutter, Mimi Leder and Christopher Chulack, were able to use the series to launch impressive careers. Others, like Ernest Dickerson, were already established names who dropped by because an hour of this NBC drama had the potential to be as interesting and epic as anything screening at the local cineplex. There’s even an episode directed by Quentin Tarantino, hot off his Pulp Fiction success. It was also a good way to nab Emmy recognition. The series won 23 Emmys over its 15 year run, and was nominated for more than 120. From 2006 to 2015, the series held the record for most Emmy nominated drama series of all time. That record was eventually surpassed by Game of Thrones.

As the series entered the 2000s, some of the technical aspects it was known for began to fade away. The stedicam sequences decreased and were replaced with more of a shaky cam or documentary style of composition, especially once shows like The Office and Friday Night Lights incorporated such techniques successfully. The series evolved over a decade and a half, but never lost sight of its purpose. It was always a hard-hitting show that celebrated medicine in America while being critical of its shortcomings.

ER was always politically charged. Throughout the series, scripts dealt with gun violence, racism, sexism, economic injustice, HIV/AIDS, addiction, homophobia, PTSD, military sexual assault, and countless other issues that many other shows weren’t talking about or were doing so half-heartedly. ER debuted around the same time that Bill Clinton lost the battle for healthcare reform and only weeks before a wave election where Republicans swept congress and steered the country, and Clinton’s presidency, in a conservative direction. The early episodes were subtle in their politics. It was a liberal show if you thought about it, but like many shows at the time, didn’t name names or parties in its critiques. As the Bush years dragged on, that changed.

I’ve seen all 331 episodes of ER, 330 of which I’ve watched multiple times. As with all old shows, some things haven’t aged well. In many ways though, the series feels as relevant now as it did two decades ago.

It’s difficult to narrow down the best episodes of such a long running series, especially since some of the best storylines cover multiple episodes or, in some cases, multiple seasons. But I’ve come up with a list I’m proud of and will stick to until at least the next re-watch, when I notice something new or a storyline hits me in a way it didn’t before. I am much more certain about the 10 worst episodes, which I will list first in the interest of getting the negative out of the way and ending with what I really want to talk about. Both lists are in chronological order.

10 Worst Episodes of ER

A Walk in the Woods (Season 7)

James Cromwell is a wonderful actor, so wonderful that he was Emmy nominated for this extra strength Tylenol storyline the writers gave him. Bishop Stewart is not a compelling character, and I don’t care about Luka’s (Goran Visnjic) struggle with his faith either. Both characters take up the most screen time in this seemingly endless hour.

Freefall (Season 10)

ER had just seemed to regain its footing early in season 10 thanks to the introduction of characters Neela (Parminder Nagra) and Sam (Linda Cardellini), as well as the plotline of Abby (Maura Tierney) going back to medical school. Then this happened. Not only is it the most embarrassing moment in the entire series, but one of the worst moments in television history.

Dr. Romano (Paul McCrane) had become pretty one note by this point. Always a blunt and unpleasant character, he at least had other sides to him that were occasionally explored earlier in his arc. After a shocking twist early in season nine where he got too close to the tail rotor of the medivac helicopter and lost his arm, he become a one-dimensional bastard who committed countless fireable offenses every time he appeared onscreen. It was clear Romano’s arc had reached a dead end, and it was time to write him out. There were believable ways to do this. He could finally be fired for his constant racist, sexist and homophobic behavior, or (slightly less believable) he could take on an administrative role at another hospital.

Instead, the writers decided to have the same helicopter that chopped off his arm crash land on him in the ambulance bay. If that’s not far-fetched enough, the editing of the scene results in almost eight seconds of Romano watching the helicopter crash and tumble towards him, ample time to at least attempt to get out of the way, rather than staring up at it and yelling “NOOOOOOOOO” like an idiot. Millions of fans swore off the show after this episode aired, which is understandable but unfortunate. As my best episodes list will show, the series did have some good ideas left after this point, but this hour was beneath everyone involved. That said, if you want to have some laughs at a really bad chapter of TV history, this is the episode for you.

Makemba (Season 10)

This is the one episode I have never been able to watch all the way through a second time. It is so boring. Some of the Africa episodes worked, and they all drew attention to a crisis that the U.S. media was barely covering, but this episode is a footnote. The only development is that Dr. Carter has a new girlfriend. Thandie Newton is so much better than every single scene and line of dialogue she was given in this series.

Skin (Season 11)

Abby is kidnapped by some gang members who want her to heal their wounded friend. This is just a less effective re-working of the season three episode where Hathaway is held hostage in a convenience store robbery gone wrong.

Canon City (Season 12)

As a TV viewer, I’ve suffered many a long wait between end of season cliffhangers. But let me tell you, in the summer of 2005, I didn’t give one thought to what was going to happen to Alex Taggart, who was last seen hitching a ride at the end of season eleven. For a show that typically began its seasons well, regardless of whether or not the previous one ended with a cliffhanger, this is just lame.

Dream House (Season 12)

There’s a pretty good storyline here involving Haleh’s (Yvette Freeman) conflict with head nurse Eve. But then there’s a dumb storyline where Abby and Neela treat a chimpanzee. I liked the season one episode Make of Two Hearts where the docs saved an injured dog. That entire storyline played out in the opening scene and was just a couple minutes long. The wounded animal storyline in Dream House is overkill.

Reasons to Believe (Season 13)

Just a dreary episode that I find annoying. I get it. The homeless kids create a make believe world to deal with an unpleasant reality. It’s still annoying.

Gravity (Season 14)

I don’t have strong feelings about this being a particularly bad episode, but like all but one or two episodes of season fourteen, it’s forgettable. Abby starts drinking again after her son injures himself and ends up in the ER. It’s kind of been there, done that in terms of her character, and no one else in this episode has anything compelling to do either.

The Test (Season 14)

Again, season fourteen is the weakest of the series, so I could randomly pick episodes and put them on this 10 worst list.

Dream Runner (Season 15)

We watch three different versions of one of Neela’s more trying shifts. It’s gimmicky filler at a time when the series should have been (and mostly was) wrapping up bigger arcs as the finale approached.

25 Best Episodes of ER

Pilot (Season 1)

Originally written by Michael Crichton in the 1970s as a film script, the project was close to being directed for the big screen by Steven Spielberg. Those plans came to a halt when Spielberg found out Crichton was writing a book called Jurassic Park. The director did help pitch the script to NBC as a pilot, and produced the show through Amblin Entertainment.

The two-hour (88 minutes without commercials) premiere of ER introduces us to the staff at Chicago’s Cook County General. The regular cast initially consisted of five characters: Dr. Greene (Anthony Edwards), Dr. Ross (George Clooney), Dr. Lewis (Sherry Stringfield), Dr. Benton (Eriq La Salle) and med student John Carter (Noah Wyle). Nurse Carol Hathaway was originally supposed to die from her suicide attempt in this episode, but Spielberg convinced the writers to keep her around. Consequently, Julianna Margulies is not listed in the credits as a series regular until the second episode. In my opinion, the initial cast of ER might still be the best ensemble for any single season of a series, especially a drama. There may be better shows, but this cast is amazing. There isn’t one character in this season that feels unnecessary or under-used. The performances are great too, which is probably why every member of the cast received Emmy nominations for this season.

Blizzard (Season 1)

Chicago weather truly was a character in ER. In the series’ best December episode, what starts off as a slow shift full of pranks turns into complete chaos after a chain-reaction pile-up fills the ER with crash victims.

It’s grisly stuff, and the episode features a delightful twist when an unlikely member of the staff performs a life-saving procedure.

Love’s Labor Lost (Season 1)

Often cited as the best episode of the series (and one of the best in television history), and I can see why. A seemingly routine visit by a pregnant patient (Colleen Flynn) turns into a horror film, and a tragedy. Dr. Greene makes a mistake, and no matter how much he tries to undo it, there’s no stopping the outcome that awaits. ER was great at making episodes that exhausted viewers to the point that they felt like they were in the trauma room, and this is one of the most finely crafted and performed examples. Love’s Labor Lost took home five Emmys, including nods for writing and directing.

Hell and High Water (Season 2)

Dr. Ross rescues a boy trapped in a storm drain during flash flooding, and also saves his career in the process. There’s a B storyline involving another child that seems for a while like it is going to be comic relief, until it isn’t. This is one of many disaster, visual effects and stunt heavy episodes that director Christopher Chulack would contribute over 15 seasons, and arguably the best.

The Healers (Season 2)

The series had showed us burn victims before, but not like this. Paramedic Raul (Carlos Gomez) suffers fatal burns while responding to a fire. This episode is fast paced, but it’s the agonizing visuals that leave a lasting impression. It’s also the first time we see the County General staff convene at Doc Magoo’s (they would later do this at Ike Ryan’s after Doc Magoo’s burns down in season nine) to mourn the loss of a friend and co-worker. This episode is helmed by Mimi Leder, who also directed Love’s Labor Lost. Leder left the show early on, but did return for the final season to direct another episode that I’ll discuss later.

A Shift in the Night (Season 2)

This is a solid episode featuring a lot of trauma action, including a car accident by Doc Magoo’s and an infant with a gunshot injury, but it stands out for the final ten minutes in which Dr. Greene shows the staff how to go above and beyond what is expected. It’s a particularly pivotal moment for Carter as well. A year later when he walks away from surgery in order to be an ER doc, you can imagine this night is one of the experiences on his mind.

Fear of Flying (Season 3)

Dr. Greene and Dr. Lewis take a chopper ride out to my neck of the woods, or very close to it, when they respond to a vehicle crash in Boone county. Benton’s arrogance leads him to make a disastrous mistake on a young crash victim.

Whose Appy Now? (Season 3)

After Gant’s (Omar Epps) death (in the episode Night Shift) brought to a head the brewing divide between Carter and Benton, there was some soul searching and a couple hard truths to explore. This episode provides a hilarious bit of falling action for that arc, as Carter gets to remove his mentor’s appendix. On a more serious note, Doug treats a teenage patient who wants to die, but whose mother won’t let go. As violent as the shootouts, porch collapses and train crashes during the later seasons were, there are few more disturbing images in this show than a terminally ill patient being held down and intubated against his will after thinking his suffering was about to end.

Exodus (Season 4)

It pains me that I only included one episode from season four on this list, but it’s a season that has more great multi-episode arcs than individual episodes. I’d say four is one of the best seasons, but it’s also one where the episodes work better together than on their own. Exodus is one of the show’s classic mass casualty episodes that finds Carter overseeing an evacuation of the emergency room after chemicals are tracked into the hospital.

The Good Fight (Season 5)

Another one of those special episodes that happened once or twice a season that focused on one patient, this hour finds Carter and med student Lucy Knight (Kellie Martin) searching the city for the father of a child with a rare blood type. If his blood type matches, it is her best shot at survival. There’s a lot of bickering between Carter and Knight, but also an inspiring level of devotion to helping a patient. The episode avoids wrapping anything up neatly. Doctors don’t always get the outcomes for their patients that they want, if they even get to know the outcome at all. It’s only fair that a show about medicine expects viewers to get a sense of that.

The Storm (Part 1) (Season 5)

The series’ only official two parter deals with Dr. Ross paying the price for his role in ending a dying child’s life. The writers throw way too much into the second part, overloading it with a bus crash, a stabbing and two staff members getting in an accident on the way to the scene of the bus crash. Fortunately, the first hour is much more focused. Ross makes a mess for everyone, but maintains he made the right choice. The scene where he is questioned by a detective is not only my favorite Doug Ross moment, but possibly my favorite scene from George Clooney’s career thus far.

The Peace of Wild Things (Season 6)

Alan Alda owns the first half of season six in a recurring role as a physician coming to terms with the onset of Alzheimer’s Disease. He has many great scenes across a handful of episodes, but it’s his talk with Dr. Weaver (Laura Innes) near the end of this episode makes the arc unforgettable.

Be Still My Heart/All in the Family (Season 6)

I am cheating a bit and counting these two as one. When I watched Be Still My Heart the first time, the episode was a masterful bit of deflection, throwing one trauma and crisis after another at us so we don’t think too hard about where Carter and Lucy’s clash over a psych patient (David Krumholtz) is headed. We all should know better than to be comfortable with B or C storylines in this show. They have a habit of becoming the A storyline, and this one does when the patient stabs Carter, who falls to the floor and sees Lucy lying wounded by the other side of the bed.

All in the Family focuses on the rest of the staff trying to save their wounded co-workers, and also fighting to keep their emotions in check when the psych patient returns in need of treatment.

Though nearly perfectly constructed and acted, the success of these two episodes had a negative impact on later seasons of the series. The writers began to rely too much on putting the main characters in danger and creating more outlandish outbursts of violence inside the hospital. None of them worked this well.

The Visit (Season 7)

Abby Lockhart is one of my favorite characters from ER, but her overall arc is a mixed bag. There are inspired storylines though, including the early episodes with Sally Field as her mother Maggie, who is bipolar. Sally Field won a much deserved Emmy for her work in season seven, which began in this episode.

On the Beach (Season 8)

Few episodes set almost entirely outside of County General work well, but this one excels. We watch Mark’s final days with his family in Hawaii. Still a healer, he has only days to repair his damaged family. Watching him deteriorate is grueling. Has there ever been a more fitting use of the word “shit?” Anthony Edwards never won an Emmy for portraying Mark Greene, and for this season he wasn’t even nominated. John Wells did receive an Emmy nomination for writing On the Beach, but lost to the pilot for 24. Talk about an Emmy win not aging well.

Lockdown (Season 8)

Arguably the show’s best season finale, this one is intense without being ridiculous (I’m talking about you, 21 Guns).

The ER is locked down after two children present with what looks like smallpox. With Greene gone, Carter is challenged to set the tone, and he does so beautifully, with a lot of help from Abby and Dr. Lewis.

Dear Abby (Season 10)

Season nine of ER struggled to do anything memorable. With exception of Pratt (Mekhi Phifer), nearly every character had been on the series for several years and the writers seemed content to drag out arcs that had already worn thin. Dear Abby, the third episode of season ten, signals a shift. Neela appeared for the first time in the 10th season premiere, but it’s here that Parminder Nagra became a series regular. Med student Archie Morris (Scott Grimes) shows up and immediately annoys everyone, and Abby suffers through a trying shift that will lead (in the following episode) to a major decision about her career.

Most of the episodes on this list have either been event episodes where a main character leaves or dies, or bottle-style episodes with self-contained medical storylines. Dear Abby is a fine example of the typical week in, week out balance of medical cases and personal storylines that make up a majority of the series’ episodes. It quietly ushers in a new era for the cast, one that doesn’t kick in fully until Linda Cardellini shows up as nurse Sam Taggart two episodes later. As for Abby, it’s refreshing to have the focus be on her medical skills after the overwrought family drama (and awful relationship with Carter) that comprised most of her screen time in season nine.

Where There’s Smoke (Season 10)

Life was going pretty well for Weaver and Sandy (Lisa Vidal), so of course one of them had to die. I’m glad the writers eventually gave Weaver a happy ending, but episodes like this had me wondering at the time if Weaver was the new Greene.

Time of Death (Season 11)

A guest acting tour de force by Ray Liotta, this episode focuses on a man who learns he has less than an hour to live. Most of the show’s trauma room scenes compress time so that an hour or two takes about a minute or so of screen time. Not in this episode. Hours like this are why enough viewers stuck around and allowed the series to stay on the air for 15 years. As weak as some later season got, occasionally the writers would come up with something like this; something so poignant and gripping that you had to keep coming back in the hopes that they would do it again. Eleven seasons in, this is still classic ER.

Blame it on the Rain (Season 12)

The show struggled a bit in season twelve, providing a few moments of brilliance buried within repetitive patient stories, splashy but hollow disaster episodes and forgettable trysts. The void left by Noah Wyle is apparent, but Blame it on the Rain hints at some remaining possibilities for the series. There’s a lot of intrigue regarding a patient visited by his sex therapist and another who wakes up after being in a coma for six years. Chicago weather returns with a vengeance, but this time in darkly funny ways. Jerry getting struck by lightning is funnier than it deserves to be.

Jigsaw (Season 13)

When he was introduced in season ten, I hated Archie Morris. Slowly though, he began to win me over, and Jigsaw is a turning point for his character that is in my view the series’ most underrated hour. Despite what I said about 24 earlier, I have to point out one great thing that came from that show, and that is writer/producer Virgil Williams. His time on 24 paved the way for a producing gig on ER. Williams also penned several solid episodes during the show’s last couple seasons (as well as one on my 10 worst list), but Jigsaw is his best written hour of television. He would later receive a much-deserved Oscar nomination for Best Adapted Screenplay for Mudbound.

Breach of Trust (Season 13)

There was a point after Sandy’s death where Weaver was mostly stuck in the background of each episode, if the writers gave her any scenes to begin with. She was mostly someone who appeared to deal with administrative matters, so it was a welcome development late in season twelve and throughout much of thirteen when the writers not only gave her stuff to do, but began expanding on aspects of her character that had only been partially developed in the past. It was surprising then when Weaver left, but her exit couldn’t be better. Like several cast members from the early years, she does make appearances in the final season.

Heal Thyself (Season 15)

It seemed unlikely that the series could create one more great character so late in the game, but from the moment Dr. Catherine Banfield (Angela Bassett) introduced herself, it was clear she would elevate whatever the final season had in store. Slowly, it became clear that her presence would provide a link back to the past, and that link was none other than a fateful encounter with Dr. Greene during his last weeks at the hospital. Heal Thyself is more than just a stunt to bring back a former cast member though. It’s an hour reminiscent of those classic early seasons that also moves the story forward and adds dimension to several of the newer characters.

A Long, Strange Trip (Season 15)

Dr. Morganstern (William H. Macy) stops by to visit his former mentor (Rance Howard), a doctor whose efforts in the 1960s changed medicine at County General forever. This episode marked Mimi Leder’s return to directing the series after a 13 year absence.

…And in the End (Season 15)

ER fittingly ends the way it began. This two-hour finale features new med students (including one played by Alexis Bledel), one last grisly trauma, the long-anticipated opening of the Joshua Carter center and an epic closing shot. Rod Holcomb, who directed the series premiere, returned to direct the finale and ended up winning an Emmy for it.

That wraps up my look back on ER. Please comment and share your thoughts on the series. What were your favorite episodes? What character did you like the most/least? Which season do you think was the best?